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Summaries Of The News:

California health officials took deliberate steps — such as expanding Medicaid — to ensure the Affordable Care Act changes were successful in their state. “What has been lost in all the rhetoric and the politics is that the system can work,” says Dr. J. Mario Molina, chief executive of Molina Healthcare Inc, an insurer that has done well under the law.

Los Angeles Times:
Obamacare Is No Disaster. California Is Proving Why
Even as turmoil in insurance markets nationwide fuels renewed election-year attacks on the Affordable Care Act, California is emerging as a clear illustration of what the law can achieve. The state has recorded some of the nation’s most dramatic gains in health coverage since 2013 while building a competitive insurance marketplace that offers consumers enhanced protections from high medical bills. (Levey, 10/7)

The Wall Street Journal:
Molina Outperforms Rivals In ACA Marketplaces
When Elizabeth Wolfe switched her insurance to Molina Healthcare Inc. earlier this year, her coverage changed dramatically. She had to stop going to her old doctors because they didn’t accept Molina. Her new health-maintenance-organization plan didn’t include some of the highest-profile hospitals in the Los Angeles area, where she lives. Losing her old doctors and switching to a no-frills clinic “was a big concern, but when we had to make the first premium payment, we got over that quickly,” she says. (Wilde Mathews, 10/6)

The county will not release the names of the facilities except for rare instances in order to protect a patient.

Los Angeles Times:
Los Angeles County Now Plans To Require Hospitals To Report Superbug Infections
Los Angeles County plans to require hospitals to begin reporting when patients are infected with a certain superbug so lethal that it can kill half its victims, health officials said Thursday. Unlike two dozen other states, California has not required hospitals to report when patients are sickened with the lethal bacteria, which federal officials warn is one of the nation’s most urgent health threats. (Petersen, 10/6)

KPCC:
LA County To Require Hospitals To Report 'Superbug' Infections
Los Angeles County intends to require all hospitals in the county to report infections caused by a class of "superbug" antibiotic-resistant bacteria, a senior public health official said Thursday. Interim County Health Officer Dr. Jeffrey Gunzenhauser plans to make it mandatory for hospitals to report cases of carbapenem-resistant Enterobacteriaceae, or CRE, according to Dawn Terashita, interim deputy director of the L.A. County Department of Public Health's acute communicable disease control program. Gunzenhauser is expected to issue the order in the next few months, she told KPCC. (Plevin, 10/6)

A transgender man is suing San Francisco-based Dignity Health for refusing to pay for his transition-related care.

KPCC:
Transgender Man's Suit Is Latest Clash Over Catholic Ethics
Josef Robinson was born a woman; he started the process of becoming a man about two and a half years ago. He began hormone therapy and planned to undergo a bilateral mastectomy as well. But Robinson, a registered nurse at a Dignity Health facility in Arizona, got some surprising news: His San Francisco-based employer, which describes itself as being "rooted in the Catholic tradition," refused to cover any of his transition-related care under its employee health insurance plan. His policy excludes all coverage related to sex transformation surgery. (Plevin, 10/7)

“Yes, veterans deserve top-notch medical care, but they also deserve an aesthetically pleasing environment in which to heal and to receive that care,” says spokesman Damian McGee.

The Mercury News:
VA Palo Alto Respond To Concerns Over Art Expenses
Members of the U.S. House of Representatives’ Committee on Veterans’ Affairs and some of the Peninsula’s top political leaders have questioned why VA Palo Alto spent $6.3 million on artwork and related consulting in the past 10 years at a time when medical care languished at other VA hospitals. The artwork debacle followed revelations that many veterans across the country had to wait exceedingly long periods for treatment and some died before ever seeing a doctor. Long patient wait times have not been an issue at the Palo Alto system’s facilities, however. (Lee, 10/6)

In other veterans' health care news —

The Washington Post:
Veterans Affairs Will Begin Covering IVF And Adoption Costs For Wounded Veterans
The Department of Veterans Affairs will begin covering costs for in vitro fertilization and adoptions for combat-wounded veterans struggling with infertility because of their injuries, giving thousands of young veteran families fresh hope at starting a family, advocates say. President Obama signed a bill last week that allows the agency to pay the costs for the next two years from existing VA health-care funds. The provision was authored by U.S. Sen. Patty Murray (D-Wash.), who said she is also pushing to fund the services permanently. (Wax-Thibodeaux, 10/6)

Twenty-nine children have been hospitalized after getting root canals at the clinic.

Orange County Register:
After Infection Outbreak, New Water System Plans Approved For Anaheim Dental Clinic
Children’s Dental Group clinic of Anaheim, whose water supply caused an outbreak of serious infections in 29 root canal patients ages 3 to 9, has received approval from public health officials for its plans for an installation of a new water system. Sam Gruenbaum, CEO of the company that owns the clinic, said Thursday that he hopes the “best in class” system will be operational in less than two months. The Orange County Health Care Agency must sign off on the final renovation, including testing the water to assure patient safety. (Perkes, 10/6)

The Associated Press:
California Tightens Rule On Popular Pesticide, Citing Health
California will tighten rules on how much farmers can use a common pesticide listed by the nation's most productive agricultural state as a chemical known to cause cancer, regulators said Thursday. The change doesn't ban the pesticide Telone but creates a uniform rule for its application each year. The rule is drawing criticism from farmers who call it a key way to fight pests and fear the crackdown could lead to rising food prices. (Smith, 10/6)

"Despite being faced with tough choices and financial imperatives, our patients must and will remain at the center of every decision we make," UC Irvine Health's chief executive, Howard Federoff, wrote.

Los Angeles Times:
UC Irvine Health Laying Off 175 Employees
U.C. Irvine Health began laying off 175 employees this week as part of a plan to ensure efficiency of its medical center's clinical and educational operations, the university-based care provider said. Those being let go — many of whom are in management or administrative and support positions — are being notified individually, according to UC Irvine Health spokesman John Murray. The layoffs will not include faculty, which includes doctors, he said. (Chan, 10/6)

In other news from across the state —

Modesto Bee:
New School At Former Heald College Site In Salida Focuses On Health Careers
American Specialty College has taken over the former Heald College site on Pirrone Court. A spokesperson said at a grand opening Wednesday that 15 to 20 students will begin courses next week to become medical assistants and certified nursing assistants. The for-profit college, in a three-story building, could serve up to 1,000 students as more education programs are accredited, the company said. In August, the state Bureau of Private Postsecondary Education approved a license for the college to operate. (Carlson, 10/6)

Santa Rosa Press Democrat:
Russian River Health Center In Guerneville Reopens After Last Year's Devastating Fire
Providers and patients who endured 8½ months of cramped, improvised facilities in the wake of a December arson fire that destroyed the Russian River Health Center are back at their old site in new digs serving the lower Russian River communities. The health center in downtown Guerneville — medical home for 3,500 patients — reopened last month at Third and Church streets in a modular structure assembled where the charred remains of the longtime clinic once stood. Spotless and orderly, the 3,300-square-foot clinic is smaller but features seven exam rooms, three restrooms, a waiting room, lab, staff offices and other facilities. (Callahan, 10/6)

Congressional leaders say the bill, aimed at promoting medical research and developing innovative medical solutions, will be one of their top priorities during the four-week session after the election.

Roll Call:
Government Funding and Medical Research to Dominate Lame-Duck Session
Last week, lawmakers raced to find a funding deal to avert a government shutdown, and they’ll be back in a few weeks to do it all over again. ... Spending fights will likely take up much of the time before the 114th Congress wraps up. But the GOP leaders in both chambers also expressed interest in passing a 21st Century Cures Act during the lame-duck. The measure is aimed at promoting medical research and developing innovative medical solutions. The bill “could end up being the most significant piece of legislation we pass in the whole Congress,” [Senate Majority Leader Mitch] McConnell said. (Bowman, 10/6)

In other national health care news —

Modern Healthcare:
CMS Posts Hospice Payment Data. But How Reliable Is It?
In 2014, Medicare spent more than $15 billion on hospice care for 1.3 million of its beneficiaries. More precise breakdowns of where those dollars went, however, have not always been publicly available. A new data set the CMS released Thursday is likely to change that, even as some raise concerns about the accessibility and reliability of other spending data provided by the agency. The Hospice Utilization and Payment Public Use File contains privacy-protected information on the services of 4,015 hospice providers to Medicare beneficiaries. (Whitman, 10/6)

NPR:
Beyond Mammograms, Screening Choices Are Far From Clear
Mammography can prevent deaths from breast cancer, but it's not a perfect test. It misses some cancers, especially in women with dense breast tissue, and flags abnormalities for follow-up tests that turn out to be benign, among other issues. So there's a lot of interest in additional tests that might make screening more accurate in women who have dense breasts. (Hobson, 10/7)

Stat:
Scientists Are Assembling A New Picture Of Humanity
Sixteen years ago, two teams of scientists announced they had assembled the first rough draft of the entire human genome. If you wanted, you could read the whole thing — 3.2 billion units, known as base pairs. Today, hundreds of thousands of people have had their genomes sequenced, and millions more will be completed in the next few years. But as the numbers skyrocket, it’s becoming painfully clear that the original method that scientists used to compare genomes to each other — and to develop a better understanding of how our DNA influences our lives — is rapidly becoming obsolete. (Zimmer, 10/7)

Commentators sound off on the measure aimed at curbing high drug prices. Also, read other opinions on health care developments from around the state.

Los Angeles Times::
Proposition 61 Is The Wrong Solution To The Problem Of High Drug Prices
Blatant price-gouging by EpiPen-maker Mylan and other pharmaceutical companies has stoked public outrage about the high cost of prescription drugs. Meanwhile, the emergence of a new class of exceptionally expensive specialty drugs has caused budget nightmares for state governments. But in California, even modest efforts to require drugmakers to reveal more about how they set their prices have been stymied by lawmakers sympathetic to the industry. (10/4)

San Francisco Chronicle:
Yes On Prop. 61: Cap Prices State Agencies Pay For Prescriptions
California voters can expect to be hit with tens of millions of dollars in prescription drug industry-funded political advertising warning that passage of Proposition 61 — a measure to cap drug prices — will stifle the industry’s ability to develop new life-saving drugs. This is a well-worn scare tactic used by drug-industry giants whenever the exorbitant prices of their drugs are challenged. It is a claim that is factually shaky, if not fraudulent. I can say this because I worked for more than three years as government-affairs director for Gilead Sciences, the patent holder of the two hepatitis C drugs whose huge price tags have shaken Medicaid budgets nationwide and put the cost of treatment for many patients out of reach. (David W. Poole, 9/30)

San Francisco Chronicle:
Chronicle Recommends: No On Proposition 61
[W]e must oppose Prop. 61, despite our disgust with the industry-bankrolled disingenuous advertising blitz. It is important to note that an array of consumer and health-advocate organizations that have no love for the pharmaceutical industry are opposed to Prop. 61. A link between Medi-Cal and the VA is not necessarily a good corollary; their respective patient bases have different demographics and medical needs. Also, the fear of reduced access to certain drugs is legitimate: It would rely to some extent on the good faith of an industry whose greedy practices were the inspiration for this initiative. (9/22)

San Antonio Press Express:
Will California Lower Drug Prices For Us All?
California may soon drive a hole through Washington’s tolerance for — and protection of — price gouging on drugs. A measure on the November ballot, Proposition 61, would bar state agencies from paying more for prescription drugs than the U.S. Department of Veterans Affairs does. Congress generally prohibits the U.S. government from negotiating prescription drug prices. The VA is an exception. Federal law ensures that it obtains a discount of at least 24 percent off a drug’s list price. (Froma Harrop, 10/3)

Los Angeles Times:
Vote Yes On Proposition 56 To Raise California's Too-Low Tobacco Tax
Everyone knows that tobacco kills, but still, the numbers are staggering. In California alone, some 40,000 adults die each year as a result of smoking or secondhand smoke, and the amount spent annually on healthcare directly related to tobacco exceeds $13 billion. Nationally, the death toll is 480,000. Americans, for better or worse, have decided that this nasty, lethal drug should remain legal. So government’s approach is to discourage smoking where it can. It restricts advertising, requires warnings on cigarette packs, bars sales to minors — and, most effectively, it levies “sin taxes” designed to make smoking prohibitively expensive. (9/30)

Orange County Register:
Latest Tobacco Tax Attempt Is A Giveaway To Special Interests
But Prop. 56 is worded to exempt itself from the Prop. 98 provisions, which would allow them to avoid sending approximately $600 million per year of tax revenue to California schools. Prop. 56 asks California voters to contradict themselves and does an end run around Prop. 98’s constitutional funding requirements to direct billions to the health care bureaucracy. Prop. 56 is being sold as a way to fund health care for low-income residents. Doctors often say they can’t take Medi-Cal patients because the payments they receive for providing care don’t cover their costs. But Prop. 56 wouldn’t fix this problem and fails to provide accountability. (Brian Fojtik, 10/6)

Sacramento Bee:
Medical Care Now California’s Biggest Industry, Dwarfing All Others
A new UCLA Center for Health Policy Research study reveals that we Californians are directly or indirectly spending a mind-numbing $367.5 billion a year on our physical well-being, equal to 15 percent of the state’s $2.5 trillion economy. That makes it, by a huge margin, our largest industry, dwarfing such high-profile California mainstays as movies, agriculture, aerospace and tourism. The $50 billion film industry, for instance, is scarcely one-seventh the size. (Dan Walters, 10/1)

Los Angeles Times:
Why Won't UC Health Centers Provide Birth Control Without A Prescription?
Under the pharmacist protocol, women seeking birth control are no longer required to endure yearly pelvic exams or the wait times associated with them—which aligns with the medical consensus advising against annual exams for healthy women. It marks a turning point in feminist history, removing paternalistic barriers to women’s agency over their bodies. Yet nearly three years after President Napolitano’s office supported the passage of the pharmacist protocol, no UC school has implemented it on campus or even made a sincere attempt to do so. (Olivia Weber, Ali Chabot, and Laura Lively, 10/6)

The Orange County Register:
Make VA Hotline Work Right, With Or Without New Law
The Department of Veterans Affairs has called it a public health crisis — an estimated 20 veterans commit suicide every day. So it is no trivial matter that a suicide hotline run by the VA is failing to answer the phone. The former director of the Veterans Crisis Line told the Associated Press that an average of 35 to 40 percent of the calls to the hotline in May went unanswered by the crisis-trained health science specialists at the VCL’s location in Canandaigua, N.Y. The calls rolled over to backup centers run by a contractor and staffed by workers, sometimes volunteers, who lack specialized training. (10/5)

Bay Area News Group:
Trump Misses Reality Of PTSD For Veterans
Jason Deitch was an Army Ranger who served multiple deployments to Africa and the Middle East. You can make the case that he still works the front lines today in his job as veteran liaison at the U.S. Department of Veterans Affairs’ Program in Rehabilitation Neuroscience. Deitch, 47, works at health facilities all over the Bay Area — in his hometown of Martinez, UC Berkeley, UC San Francisco — spending time with combat veterans suffering from mental health issues such as post-traumatic stress disorder (PTSD). So he listened carefully when he was read something Republican presidential nominee Donald Trump said to a group of veterans in Virginia on Monday. (Gary Peterson, 10/3)

Los Angeles Times:
Bill Clinton Was Right That Obamacare Needs Improvement — But We Knew That Already
My quiet afternoon was interrupted Tuesday by an outburst of blather on CNN about a gaffe that Bill Clinton had uttered, supposedly calling the Affordable Care Act “the craziest thing in the world.” There followed lots of speculation about how Hillary Clinton would tamp down the controversy, lots of chortling over whether the time had come to put a leash on the ex-president lest he embarrass his wife again, etc., etc. You know the drill. (Michael Hiltzik, 10/5)

The Mercury News:
Make End Of Life Options Real With Palliative Care
While controversy remains about California’s recently passed End of Life Option Act, we need to accept that aid-in-dying is now legal and that the state needs to support additional real options for patients—especially good palliative care with its focus on the whole-person and pain management. Alarmingly, California falls woefully short in providing universal access to palliative care. Community-based palliative care is currently unavailable in 22 of our 58 counties; there are no inpatient services in 19 counties. Specialists in palliative care are in short supply and reliable funding is nonexistent. Most rural communities in the state have limited, or no, access to this vital service. (Margaret R. McLean, 10/5)

Los Angeles Times:
This Newport Beach Doctor's Work Has Changed Pediatric Care Throughout The World
Many years ago, as Dr. Zeev Kain watched a 3-year-old get wheeled to an operating room for a tonsillectomy, a colleague turned to him and said, "The walk to the OR for a child is the longest place in the world." The remark captured precisely what Kain had been feeling. As a pediatrician and anesthesiologist, he had become increasingly concerned about the pain and anxiety endured by children undergoing surgery and other invasive medical procedures. (Patrice Apodaca, 10/6)

Sacramento Bee:
Parents Should Be Wary Of Marijuana Legalization
Marijuana is a complicated issue. I support its medicinal use and have introduced federal legislation to make it easier to research and potentially bring marijuana-derived medicines to the market with FDA approval... But Proposition 64 would allow marijuana of any strength to be sold. (Dianne Feinstein, 10/1)